What to do when in SVT (supraventricular tachycardia)?

Posted by ashby1947 @ashby1947, Jan 7, 2020

I have had several episodes of SVT, the last of which landed me in the hospital for several days and a change of medication to diltiazim (along with my many others). I will be reviewed by an EP in a few months (!) and probably discuss having an ablation. I have a very complicated heart history – open heart surgery to repair mitral valve, episodes of Afib, cardioversions, an ablation, etc., but overall am in very good health. My heart and I get along pretty well! This SVT is annoying, however. When I’m in an episode, I try vagal maneuvers, which has worked a couple of times. Otherwise, I have to head to the hospital with my heart rate thundering at 160 – 190. I’m not really frightened by all this, probably because I”ve been through so much; however, the fear of SVT is ever present. This causes me to restrict airplane travel and activities which would involve not being close to a hospital. I mean, what do I do at 35,000 feet when I can’t get my heart rate down and I’m 4 hours ( 8 hours on an oversees flight) away from land? If you have had any experience with SVT, I would welcome your experience and suggestions. I hope this finds you all well! Thank you, Sue

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@kanaazpereira

Hello @ashby1947,

Supraventricular tachycardia (SVT) is caused by faulty electrical signals in your heart that originate above your ventricles. Your ventricles are the lower chambers of your heart, and if there’s an extra electrical pathway (or pathways) in your heart between your atria (the top chambers of your heart) and your ventricles, it acts like a short circuit. https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/symptoms-causes/syc-20355243

Treatment for SVT aims to control your heart rhythm and rate, and depends on your symptoms. Some people don’t need any treatment at all, and symptoms may go away on their own. Most people with SVT are able to fly safely – flying does not increase your risk of having an episode. Make sure to stay well hydrated and avoid caffeine.

I’ve had SVT ever since I can remember, so I do know how debilitating these episodes can be. There were no restrictions placed on flying, and I underwent cardiac ablation a few years ago – my episodes were getting prolonged, occurred very often, and I couldn’t stop the fast heart rate with any of the vagal maneuvers. In my case, my heart rate was 210 beats per minute –– in SVT, your heart may beat between 140 to 250 beats per minute. Most people experience an improvement after SVT ablation, but there’s a small chance that palpitations may return, and the procedure can be repeated.
But, here I am, and so far so good!

Fortunately, SVT is rarely life-threatening, yet if your heart races for more than a few minutes, or if you start experiencing chest pain, you should go to the emergency room. SVTs are not considered to be dangerous or life threatening, but frequent episodes can weaken the cardiac muscle over time.

I’m tagging @ronbyrd @sue225 @ajmario @ktcrosswalk1 @jigglejaws94 @loli @cheris @martishka @texas7777 @mikeyp @anniegk @predictable to see if they can shed more light on your situation. You may also wish to view these discussions on Connect:
– Supra Ventricular Tachycardia (PSVT) and Running https://connect.mayoclinic.org/discussion/supra-ventricular-tachycardia-psvt-and-running/
– Feeling Skipped Beats, Palpitations: What could this possibly be? https://connect.mayoclinic.org/discussion/what-could-this-possibly-be/
– New and totally lost https://connect.mayoclinic.org/discussion/new-and-totally-lost/

@ashby1947, has your doctor mentioned if medication could be causing these episodes?

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I recently wore a heart monitor for 2 weeks and had frequent SVT episodes along with other symptoms of what I call " nerve dumping" I will get internal vibrations and SVTs/PACs and then like a release when it's over and I feel nerve pain I mostly in my left side and right Glute. It's the oddest thing, but no doctor in my area can explain it.
My SVTs/PACs started suddenly about 5 months ago. Should i be concerned about a sudden onset? I've had an ECHO and 2 EKG that show them, but my cardio says my heart is healthy. I find it odd that these started abruptly and wake me frequently in the night as well.

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@brayimee

I recently wore a heart monitor for 2 weeks and had frequent SVT episodes along with other symptoms of what I call " nerve dumping" I will get internal vibrations and SVTs/PACs and then like a release when it's over and I feel nerve pain I mostly in my left side and right Glute. It's the oddest thing, but no doctor in my area can explain it.
My SVTs/PACs started suddenly about 5 months ago. Should i be concerned about a sudden onset? I've had an ECHO and 2 EKG that show them, but my cardio says my heart is healthy. I find it odd that these started abruptly and wake me frequently in the night as well.

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@brayimee Hi I am so sorry you are not having much luck with the symptoms your having. I suffered with VT for quite a while and can honestly relate. I read thru your past posts and my question is have you actually seen a specialist in Electrical issues with the Heart. I see you mentioned a Cardiologist but there are different specialists in that field. You may want to find one called an EP Cardiologist who specializes in the electrical areas of the Heart and also even within EP's there are some that lean towards Afib and others that are more towards VT type issues. But I know those feelings of pain after an episode. They sound like Arrhythmias or basically a fast heartbeat but there different. Depending on what part of the heart is moving fast it starts to quiver and blood basically stops flowing. So when your heart returned to a normal beat it's like the feeling you get when as we used to call it "my arm fell asleep" when the circulation got stopped. But when it's your whole body it is a bit different. So my suggestion is to find a doctor that specializes with SVT. If you would like and let us know where about you live maybe someone here knows some good places in your area.
Have a Blessed Day
Dana

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Oh wow! Yes, I do feel that fall asleep pins and needles feeling and the nerve pain I feel is a burning in my left flank, along side my left navel along with a general ache, down into where I broke my left foot and in my right glute ( maybe sciatic nerve), I get very weak legs, I also become very bloated and full feeling frequently like my intestines shut down. So many weird symptoms, but I feel they coincide with my heart.
I hadnt realized there were different specialists. I've only seen a Cardiologist whom I see tomorrow to discuss my symptoms because I was t satisfied with his answer that they were not dangerous and if symptoms are to much, he'd give me medication. I thought he'd be more concerned that I've suddenly developed these episodes and I can't excersize these last 5 months because of these issues. Going up stairs raises my pulse to 150. For a thin, normally healthy person, I feel this is not normal.
I am in the Grand Rapids, MI area.
I sure do appricate all and any advice and help.
I also started a post of my own Internal vibrations and nerve "firing"
Aimee

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@noydb

First, find a cardiologist whom you trust and can easily discuss EVERYTHING. My husband was in a situation similar to yours; I'm an RN and accompanied him to everything. After 2 scary hospitalizations, endless testing, recommendations, certain suggestions he did NOT want to follow… We decided on ablation. It is a very common established procedure, and very low risk in the hands of an experienced interventional cardiologist. Don't be afraid to ask the doctor about his complication rate, experience, alternatives to ablation, etc. For example, my husband did NOT want an ICD, but he also didn't want any more adenosine.

The procedure went very well, and he's been symptom free since that very day! Keep in mind: you'll need to be on a blood thinner for a while, the procedure is typically done under general anesthesia, be certain you get a clear picture of the risks and benefits of both the procedure and the anesthesia, and that you'll need pre- and post-procedure testing and follow up. He is doing great, and we're very happy with our decision.

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Noydb – Happy for the positive outcome.
How long following ablation was your husband allowed to stop the blood thinner?
I have had one elctrophysiologist tell me he would take me off after 3-4 months of constant sinus rhythm. Two others say you need to stay on a blood thinner for life. Are they just altra conservative? Maybe others have experience with this also? Staying on blood thinner scares me since am always banging myself up & history of nose bleeds. Have been in sinus rhythm for 5 months post ablation. Feel fine. No other underlying.

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@nancirae

I had SVT . Best thing I ever did was have the ablation. Didn't have to be on blood thinner.

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to Nanci and noydb – Always nice to read the success stories you both share with ablation. I had an ablation in March and thankfully remain in sinus rhythm. EKG confirmed at post 4 months – now going on 7 with no underlying issues. Do have occasional PAC's but not often. My Mayo doc said I would have to be on a blood thinner for life ? Another cardiologist said could drop blood thinner after 3-4 months with aspirin if remain in constant rhythm. Very active and always beating myself up. Xarelto scares me with bleed risk. Don't want to be on this long term.
Most interested in circumstances allowing your docs to not require or stop blood thinners.
ray

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All, I am new to the group. I'm 53 and have had SVTs for 20+ years. Mine last hours and thanks to my Kardia device, I finally caught them and have been referred for an ablation procedure. My question is this. Once the cardiologist identified them, he put me on Metatropolol, which has caused weight gain, headaches, digestive issues and overall lethargy. I'm not a fan of how I feel or the prospect of staying on them for life (one solution to ablation provided by EP). I am very active and do not like how I feel or the side effects I'm having. My EP just recommended switching to Diltiazem. After reading more about this medication, I'm worried about making the switch. Can anyone share their experiences with either of these meds? I'm going back in Feb. to talk next steps, but am definitely leaning toward ablation as opposed to lifelong meds. Thanks!

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@lisadib

All, I am new to the group. I'm 53 and have had SVTs for 20+ years. Mine last hours and thanks to my Kardia device, I finally caught them and have been referred for an ablation procedure. My question is this. Once the cardiologist identified them, he put me on Metatropolol, which has caused weight gain, headaches, digestive issues and overall lethargy. I'm not a fan of how I feel or the prospect of staying on them for life (one solution to ablation provided by EP). I am very active and do not like how I feel or the side effects I'm having. My EP just recommended switching to Diltiazem. After reading more about this medication, I'm worried about making the switch. Can anyone share their experiences with either of these meds? I'm going back in Feb. to talk next steps, but am definitely leaning toward ablation as opposed to lifelong meds. Thanks!

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Hi, After 7 Er visits where they stopped my heart and restarted it I decided to go for the ablation. Best thing I ever did. Never had another SVT. Why are you waiting so long? Go for it.

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@nancirae

Hi, After 7 Er visits where they stopped my heart and restarted it I decided to go for the ablation. Best thing I ever did. Never had another SVT. Why are you waiting so long? Go for it.

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Hi,
So long because they could never identify the trigger. Looks like PACs are the trigger. The doctor really pissed me off, so I'm going to another in February.

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I am diagnosed with SVT. My resting heart rate goes up to 220 bpm. Had ablation, not successful. Take 240 diltiazem daily, still have episodes. Propanolol as needed, does nothing. The only thing that works is xanax🤔🤔. Makes me wonder if it's really SVT or anxiety?

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@lisadib

All, I am new to the group. I'm 53 and have had SVTs for 20+ years. Mine last hours and thanks to my Kardia device, I finally caught them and have been referred for an ablation procedure. My question is this. Once the cardiologist identified them, he put me on Metatropolol, which has caused weight gain, headaches, digestive issues and overall lethargy. I'm not a fan of how I feel or the prospect of staying on them for life (one solution to ablation provided by EP). I am very active and do not like how I feel or the side effects I'm having. My EP just recommended switching to Diltiazem. After reading more about this medication, I'm worried about making the switch. Can anyone share their experiences with either of these meds? I'm going back in Feb. to talk next steps, but am definitely leaning toward ablation as opposed to lifelong meds. Thanks!

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The first diltiazem I took gave me laryngeal edema, my usual reaction to meds I am allergic to.

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